Brain Damage or Encephalopathy

Examination of early symptoms

Most countries have occupational medicine clinics which examine possible solvent-intoxicated patients. In order to demonstrate such intoxication, the following questions must be answered:

1. What is the diagnosis? - Is it a case of brain damage or encephalopathy?

2. When did the symptoms occur? - Are they work related?

Several methods can be used for making the diagnosis "brain damage". The examination should be based on the patient’s own description of both the progress and the consequences of the disease. It is important to establish whether a consistent pattern of the disease exists.

If the first step in the examination leads to a suspicion of possible brain damage, the next step will be a psychological examination. A more detailed description on the progress of the disease will be made, including possible concentration problems, loss of memory, and changes in the patient’s personality or emotional state. These functions are tested by means of a number of standardised test which make it possible to verify suspected brain damage and to establish how severe the damage is. The examination may be supplemented by X-ray tests of the brain by means of newly developed methods, such as brain scanning.

When analysing the results, it is important to take various factors into consideration, such as age, work stations, and exposures. It is also important to know whether there may be other causes of the brain damage, for instance after-effects of concussion, encephalitis, or lead intoxication.

In the last ten years, Denmark has established several training centres, where patients with solvent-induced brain damaged are treated. Both psychological and social support is offered to the patients and their families. Many workers have been able to re-enter the labour market on conclusion of the treatment.

Chronic toxic encephalopathy in Denmark. Diagnosed cases 1981-1993. Calculation based on diagnosis from one country in Denmark with 10% of the Danish population.

Source: Dr. Per Gregersen, Dept of Occupational Medicine, Køge Hospital, Denmark